Raising high-density lipoprotein cholesterol levels as an important determinant of benefits associated with dyslipidaemia therapy
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Data from the Framingham Offspring Study from 1975 through 2003 was used to determine whether increases in high-density lipoprotein cholesterol (HDL-C) after initiating dyslipidaemia therapy were independently associated with a reduction in cardiovascular (CV) events. Cox proportional-hazards regression analysis revealed that the change in HDL-C was a strong independent risk factor for CV events after adjusting for the other treatment-related lipid changes. This relationship remained stable across a wide range of patient subgroups, and was not associated with any specific drug-class. However, one important interaction was found: the lower the pretreatment low-density lipoprotein cholesterol level, the greater the impact of raising HDL-C. Thus, raising HDL-C levels with commonly used lipid medications initiated at a time when therapeutic guidelines primarily targeted low-density lipoprotein levels appears to be a relevant determinant of the benefits associated with dyslipidaemia therapy.
Abstract
